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CAR: “Staff are exhausted. New outbursts of violence can start at any minute”

23 May 2017

Johan Berg works as a doctor for Médecins Sans Frontières in Bangassou, in the Central African Republic where there’s been recent violence. “I was woken by our logistics department at 6am Saturday morning, informing me that there was open fighting in the town. I did not expect it would happen so suddenly, even if I knew there was a high risk.

Only shots being fired could be heard. All the bridges leading to the hospital had been destroyed, making it impossible for us to reach the hospital by car. Our ambulance, parked at the hospital, met us at the river and the team crossed on foot. The security situation did not allow me to go to the hospital that first day and it was hard to keep still without being able to do anything to help. The next day I arrived and a part of town next to the hospital, was set alight. We still heard bullets flying and the only people that dared to come to the hospital were those with no other choice: the wounded, many of whom had gunshot wounds.

Normally, around 100 patients per day come to our emergency room, most of them children. But on that day none came and to my knowledge, most, if any, of the health centres were not operating. The patients that come to our hospital are usually very ill, especially at the moment since we are in the middle of the malaria season. It was hard to know that all these patients who would normally come to our hospital, were out in the villages and in the woods hiding without any treatment. We know that this means that many of them will die and that those who survive will be very ill when they finally dare to come.

"We still heard bullets flying and the only people that dared to come to the hospital were those with no other choice: the wounded, many of whom had gunshot wounds"

On Monday, the wounded kept coming. Many were severely hurt. We also saw children convulsing from severe malaria, unconscious because of low blood sugar and/or anemia. We saw people in severe emotional shock. One woman, who was five weeks pregnant, had seen her husband killed in front of her eyes. After that she was tied down and beaten with rifle butts. She, like hundreds of others had fled to the hospital to seek protection. She was 20 years old and was there with her four children. The stress was too much for her. She could barely stand up, let alone walk. Many of our national colleagues were missing. Progressively we received news of their wellbeing and now have news from almost everyone. Some staff are staying at the hospital; many of them arrived with their children and do not dare to leave. Many have also fled the violence and are hiding.

We lack many of the people who are crucial in ensuring that the hospital services continue running in a moment of such high need: nurses, but also support personnel such as cleaning staff. Some people work for 24 hours straight. After that, they sleep a few hours and start work again. Since all the markets are closed and the security situation makes it impossible for airplanes to land, it is difficult for us to find enough food for both patients and staff. We have only one surgeon who is working as fast as he can but the high number of patients means that many have to wait for surgery. Staff are exhausted. New outbursts of violence can start at any minute. We have received reports of several deaths from the fighting. It is unclear exactly how many. The Red Cross had to borrow body bags from us to be able to bury some of the dead.